China makes headway in building county-level medical consortia

BEIJING -- In its ongoing effort to improve grassroots healthcare infrastructure and accessibility, China has made significant strides in developing closely integrated medical and health consortia at the county level.

In 2019, the National Health Commission (NHC) launched a medical consortia pilot program, which has seen the participation of 828 county-level regions across the country to date, Fu Wei, an NHC official told a press conference on Friday.

The program aims to establish a triage system that is led by county-level hospitals and improve the capacity of medical and health institutions at the township and village levels. The end goal is to ensure that common diseases are treated at the city or county level while routine health concerns are managed at the grassroots level, according to the NHC.

Over the past five years, China has seen improvements in its county-level medical resource distribution, medical services and overall service capacity at the county level, Fu said.

The Chinese government recently released a comprehensive set of guidelines in this regard, setting the goal of ensuring that medical consortia "basically achieve full coverage" in all county-level regions by the end of 2027.

ENHANCED SERVICE

Luxian County in Sichuan Province, southwest China, started to pilot county-level medical consortia reform in 2019.

According to Ma Jinyu, the county's deputy head, three such consortia have been created in the county based on local features, as well as the public's needs.

With the development of such medical consortia, measures, such as analysis and discussion on complicated cases and personnel training, have been made to direct personnel, technology, services and management to the primary level, said Ma.

People are now able to enjoy better quality medical services at the grassroots, Ma noted.

In 2023, the number of patients referred to branch hospitals from general hospitals saw a 61-percent year-on-year increase, he said, adding that general hospitals have assisted branch hospitals with remote consultation, imaging diagnosis, and ECG diagnostics, among others.

The development of the consortia allows for more sophisticated medical services for the people, according to Ma. For example, patients with specific requirements can pay bills and fees at branch hospitals before undergoing exams or tests at general hospitals, reducing their financial load and waiting time.

POLICY SUPPORT

Fu noted at the press conference that government support will be necessary for this endeavor, highlighting the central government's financial support for rural medical services and institutions as well as local governments' preference for grassroots medical institutions when allocating new financial expenditure on health.

The government also introduced medical bill reimbursement policies that encourage people to use grassroots medical services. For example, differentiated medical insurance payment policies have been implemented for medical institutions at different levels in terms of inpatient services, said Huang Xinyu, an official with the National Healthcare Security Administration.

Speaking at the press conference, he noted that the lower the level of the medical institution, the higher the reimbursement rate and the lower the deductible.

According to the NHC, the purpose of establishing closely integrated medical and health consortia at the county level is to systematically reorganize and optimize the allocation of medical resources within counties.

Accordingly, the initiative requires efforts to optimize medical resources in county-level areas and to make quality medical workers, technologies and services more accessible at the county level, Fu said.

She said that authorities in charge of healthcare and medical institutions at the county level should enhance their capability of serving residents, including strengthening cooperation with urban hospitals for better handling of major diseases, medical emergencies and other issues, expanding family doctor services, and making it more convenient for patients to be examined at grassroots medical institutions and diagnosed at higher-level institutions.

"County-level areas constitute the foundation of the national governance system. If each county has a well-established integrated medical and health consortia, the foundation of the grassroots network becomes more solid, therefore, providing a robust basis for building a healthy China," Fu said.